New Bladder Management standing order

Foley order panels change March 11

New: Nurses can enter “Bladder Management Protocol” per standing order (see algorithm below for details) unless the provider has specific orders (Example: Due to obstruction or surgery specific orders).

The Nurse Initiated Removal of Urinary Catheter HOUDINI protocol/policy is being replaced by the Bladder Management and HOUDINI Protocol/Policy. Existing exclusions for the non-surgical and surgical foley panels will continue for Inpatient Rehab and Women & Children’s Services departments. This change goes into effect March 11.

This means:

• Non-Surgical and Surgical Foley Panels have been revised with the Bladder Management Protocol.  There are some specialty surgical order sets that will remain the same — for example Thoracic and Lumbar microdiscectomy — since they have unique instructions.

Changes include:

• Pre-selected “Foley Catheter Insertion and Removal per Protocol (HOUDINI)” order with new links.
• New “Do Not Remove Foley Panel” that includes Catheter Care order.
• “Bladder Scan and Straight Cath PRN” order has been removed and replaced with “Initiate Bladder Management Protocol” order.
• New “Remove Foley Catheter panel” order that includes the Bladder Management Protocol post removal.

The protocol will allow nurses to bladder scan and intermittent straight cath up to four times in 24 hours prior to calling a provider for consideration of a foley. When foley is placed for urinary retention, it will be removed after three midnights in the morning to begin voiding trial and intermittent straight catheterization for another 24 hours.

Please see Provider Epic tip sheet and Bladder Management algorithm, below, for further details: